The thyroid gland is a small, butterfly-shaped gland at the back of the throat. It performs many vital functions, including regulating the body's metabolic rate, controlling the heart, bone maintenance, etc. Thyroid dysfunction — resulting in too little thyroid hormone (hypothyroidism) or too much (hyperthyroidism)— is common in older adults, especially if you have a history of diabetes or rheumatoid arthritis or have a family history of thyroid conditions. Having said that, its diagnosis in the geriatric age group poses a challenge, as ageing is also associated with a number of other changes and commodities that can affect thyroid function test results. In fact, the symptoms of thyroid diseases in the elderly are often attributed to normal ageing.
In an exclusive interaction with OnlyMyHealth editorial team Dr Sudheer Koganti, Consultant Cardiologist, Citizens Specialty Hospital, Hyderabad explains dysfunction in thyroid and cardiovascular risks, particularly in older adults. Here is what is shared with us.
The early detection and treatment of thyroid dysfunction through regular screening is crucial and recommended as fluctuating thyroid levels can have an adverse effect on other organ systems, including the heart. Increasing blood pressure, irregular heartbeats or heart rate and heart failure are some of the common consequences experienced by patients.
Hyperthyroidism-induced CV problems in older adults
As mentioned, the thyroid hormone has at least some effect on every organ in the body, including the heart where it influences the speed of the heartbeat, blood pressure, and cholesterol level. As a result, a malfunctioning thyroid gland can cause cardiac problems or can even accelerate underlying cardiac problems in the geriatric age group.
In all hyperthyroid patients every function of the body tends to speed up, including that of the heart, owing to the overproduction of thyroid hormone. As a result, the force of contraction of the heart muscle increases, so does the amount of oxygen demanded by the heart and also the heart rate.
Unlike younger patients, older patients may experience only minor symptoms like the sensation of heart fluttering, and some chest discomfort on climbing stairs which often tends to go unnoticed. Patients with coronary artery disease may experience worsening angina or even a heart attack.
Similarly, hypothyroidism which is very common in patients over the age of 60, especially women, may go undiagnosed. However, unlike hyperthyroidism, the symptoms of hypothyroidism are very non-specific. More so in older patients as the frequency of multiple symptoms decreases in the ageing population. Symptoms such as memory loss or a decrease in cognitive functioning, also attributed to advancing age, maybe the only symptoms experienced by an individual.
Additionally, hypothyroidism can have severe consequences on the heart. Due to the underproduction of the thyroid hormone, neither the heart nor the blood vessels are able to function normally. This in return causes the heart muscle to pump less vigorously and become weak. The heart muscles fail to fully relax which results in diastolic dysfunction, a condition that can even lead to heart failure.
Similarly, hypothyroidism can also cause blood vessels to stiffen, causing high blood pressure, shortness of breath (dyspnea), myxedema (swelling), slow heart rate and worsening of coronary artery disease (CAD).
Thus, thyroid hormone dysfunction, be it in excess or deficient can induce CV disorders, such as atrial and ventricular arrhythmias, dyslipidemia, atherosclerotic vascular disease and heart failure, thereby contributing to a risk of premature morbidity and death in many cases.
As the risk for both incidents of heart failure and thyroid disease in the geriatric population points towards a growing burden of both diseases in the coming decades. Therefore, managing thyroid disease can have far more benefits than just reducing your risk of CV diseases. So if you exhibit any signs, have a family history of thyroid conditions, or are experiencing new or worsening cardiac health problems, make sure to get yourself tested for thyroid disease.